Differentiation of groups of patients with cognitive complaints at breast cancer diagnosis: Results from a sub‐study of the French CANTO cohort

Abstract

Objective Cognitive complaints are more frequent in women with breast cancer (BC) than in healthy controls and can be present before any treatment. Findings regarding contributive factors remain inconsistent. This study aimed to identify different groups of patients with cognitive complaints at BC diagnosis and to determine whether these different groups were associated with demographic, medical, or psychological characteristics. Methods Cognitive complaints were assessed in a subset of 264 women from the French multicenter prospective CANTO cohort, at baseline before any treatment. Clustering analyzes were performed using the six‐cognitive dimension Costa's scoring of the FACT‐Cog V3. Univariable analyses were used to study how cognitive function (standardized neuropsychological tests, ICCTF), anxiety, depression, fatigue, and quality of life (HADS, FA12, QLQ‐C30) were associated with specific cognitive complaints groups. Results Results included 263 women (54±11 years), newly diagnosed with BC (69% stages I–III). Four distinct groups emerged, ranged from “no complaints” (22.8%), “low complaints” (55.1), “mixed complaints” (14.5%), to “consistent complaints” (7.6%). No significant differences were found in terms of demographic and medical factors between the four groups. However, the groups with higher proportions of patients with complaints were found to have more impairment in executive function, higher scores of anxiety, depressive symptoms, and fatigue, and lower quality of life, than the groups with lower proportions of cognitive complaints. Conclusion Using complete cognitive assessment prior to BC treatment, we identified four distinct cognitive complaints groups with specific characteristics. This work provides valuable clinical basis to further investigations for a better understanding of cognitive complaints and their associates.

Distinct Cognitive Function Profiles Are Associated With a Higher Presurgery Symptom Burden in Patients With Breast Cancer

“…Similar to anxiety and consistent with previous reports, 9,13 progressively higher levels of depressive symptoms were associated with worse levels of cognitive function. Whereas the moderate class reported subsyndromal levels of depressive symptoms (ie, 13.7), 36,37 the low-moderate class had total CES-D scores (ie, 19.4) that warrant clinical evaluation.…”

“…6 The fact that CRCI can occur before treatment suggests that inflammatory cytokines induced by the tumor itself trigger inflammatory processes and neuroanatomic changes (eg, white and gray matter loss 5 ). However, across 6 cross-sectional studies, [7][8][9][10][11][12] findings are inconsistent regarding presurgical risk factors for CRCI. Whereas in 3 studies 7,9,11 no association was found with age, in 3 studies, 8,10,12 younger patients reported worse cognitive function scores.…”

“…However, across 6 cross-sectional studies, [7][8][9][10][11][12] findings are inconsistent regarding presurgical risk factors for CRCI. Whereas in 3 studies 7,9,11 no association was found with age, in 3 studies, 8,10,12 younger patients reported worse cognitive function scores. In terms of education, whereas in 3 studies 8,10,12 no association was found, in another study, 9 lower levels of education were associated with higher levels of cognitive complaints.…”

Pre-Surgery Demographic, Clinical, and Symptom Characteristics Associated with Different Self-Reported Cognitive Processes in Patients with Breast Cancer

“…Interestingly, higher levels of fatigue and sleep disturbance that exceeded clinically meaningful cutoffs were associated with all classes across the AFI subscales. These findings are consistent with our previous report that used the AFI total scores [30] and with other studies that found that higher levels of anxiety [12,18,27,59], depression [12,59], fatigue [12,60], and sleep disturbance [12,59,61] were associated with CRCI. These findings suggest that CRCI and common co-occurring symptoms may share the same underlying mechanism(s) that affect working memory, inhibitory control, and cognitive flexibility.…”

Baseline quality of life and chemotherapy toxicities in patients with early breast cancer

“…CANTO‐PRED is an ancillary study of the CANTO trial. The CANTO cohort has been previously described 16–20 . Briefly, it is a prospective cohort study (ClinicalTrials.gov identifier NCT01993498) enrolling women with newly diagnosed, stage I–III, invasive BC in 26 French centers.…”